Sentinel Node Concept Sentinel node dissection was first applied for the evaluation of inguinal nodal basins in patients with penile cancer(23). The sentinel node concept is based on the belief that certain anatomical areas are drained by individual nodal chains with the first lymph node in this chain being the sentinel node. It has been shown the sentinel node is predictive of the status of the lymphatic basin for the presence of metastatic disease to non-sentinel nodes. The use of both lymphazurin blue dye and technetium-99m sulfur colloid has been shown to reliably identify sentinel nodes in many cancers such ad melanoma, breast and colon. This technology has also been studied in patients with vulvar malignancies and has been shown to detect a sentinel node 100% of the time(22). With a limited number of sentinel nodes obtained from a lymphatic basin a more complete pathologic evaluation of the lymph node can be performed. The use of ultra-staging (serial sectioning) allows for smaller metastasis and micrometastasis to be reliably detected. Sentinel lymph node technology will allow for a more complete surgical and pathologic evaluation of the inguinal lymphatic basins with a potential benefit of avoiding a complete inguinal node dissection for patients with a SLN determined to be negative for metastatic disease.